Do you remember James Bond? The fictional British secret service agent 007, who tooled around in an Aston Martin DB5 (which cost as much as a semi-detached house) fitted with machine guns. In movie after movie, he slept with an array of gorgeous women—including one named Pussy Galore. He was portrayed as a hero, like so many gunslingers in Westerns. He had a “license to kill.”

Killing without a license is wrong. While you and I don’t have such a license, our societies allow quite a number of people to kill with impunity, either for political power or for profit.

Health Insurance Companies

Don McCanne, MD, estimates that tens of thousands of people die each year as a result of being denied care by their insurance companies. Those aren’t prosecuted as murders.

I’ve been seeing lots of newspaper editorials, op-ed pieces, and statements from politicians telling us how horrible it was for Luigi Mangione to shoot Brian Thompson, the CEO of a United Health Care (UHC). Telling us that killing doesn’t solve social problems.

A right-wing commentator in the New York Times even said that Thompson, who received over $10 million a year for denying health care to the sick and causing untold numbers of deaths, was a working-class hero because he’d grown up poor. Andrew Witty, the CEO of UHC’s parent company United Health Group—who gets over $23 million a year for denying care—was given space in the Times to say how much good his outfit does, though he conceded that they need to make some (unspecified) changes. It turns out they already have started making changes—they’re hiring more security guards.

United Health Care made a profit of $22 billion in 2023. By my calculations, and those of my math teacher friend Martin Rosenthal, that’s enough to build housing for all the 630,000 homeless in this country, at approximately $35,000 per apartment.

Heads of State

If I included all the monstrous heads of state in human history this post would go on forever, so let’s stick with a few contemporary examples. We have Vladimir Putin, Mohammed bin Salman, Bashar al-Assad, Rodrigo Duterte, and Abdel Fattah el-Sisi still among the living. Included in those they have tortured and slaughtered are many of their own fellow citizens.

Our society does not consider as murderers those who started or pursued military actions against other nations. I’m not speaking of self-defense, but wars against countries that had done them no wrong whatsoever. Examples here would include American presidents from Eisenhower through Ford (Vietnam wars, 1955-1975) and G.W. Bush through Obama (Iraq war, 2003-2011).

In some cases, presidents even ordered the killings of United States citizens. An ACLU press release from November 8, 2010, revealed that “the Obama administration today argued before a federal court that it should have unreviewable authority to kill Americans the executive branch has unilaterally determined to pose a threat.”  The judge in that court (Al-Aulaqi v. Obama) abstained from ruling, tacitly approving of this license.

In other words, since 2010 a President—Donald Trump, for example—can legally declare any one of us a terrorist and have us killed.

The heads of state don’t kill all that many people by themselves, of course. They order police and military to do the dirty work. When I discussed the invasion of Ukraine with a friend, she said that Russian soldiers don’t have a choice—they will be tortured if they disobey. I disagreed. There are always choices. The excuse that “I was just following orders” didn’t go over well at the Nuremberg trials.

The Tobacco Industry

The World Health Organization reports that tobacco kills more than 8,000,000 people per year around the globe. According to the Campaign for Tobacco Free Kids, the annual death toll in the United States is 480,000. Total revenue for tobacco in the United States in 2024 is estimated at $107.5 billion. The profit margin for this industry is 86.62%. Why is it so high? According to the National Institutes of Health, “because they sell very addictive products that cost little to make, require very little on-going R&D expenditures on their key products, and can sell their products at relatively high prices.”

Big Pharma

People who are caught selling illegal drugs go to prison. People who make fortunes selling deadly drugs go to country clubs.

Starting in 1996, the Sackler family, owners of Purdue Pharmaceuticals, marketed OxyContin as non-addictive when in fact it was highly addictive. In addition to their fleet of sales reps, they paid 3,000 doctors to promote the drug. Arthur Gale, MD, wrote that “In the years that followed, the painkiller generated more than $35 billion in revenue for Purdue Pharma….During the 20-year period between 1999 and 2019, nearly a quarter-million people died from overdosing on prescription opioids like OxyContin.” As of 2022, estimated deaths from the resultant opioid epidemic topped 450,000 in the United States alone.

The Sacklers withdrew $11 billion from the company and stashed it in overseas accounts. As of today they are still negotiating a deal to pay fines. None of the perps has done time, not one day.

In 2012, Insys Therapeutics started marketing Subsys, a form of fentanyl. They also bribed doctors to prescribe and promote the drug, which brought in $330 million in net revenue for Insys in 2015.   More than 8,000 people died from taking it. In this case, billionaire CEO John Kapoor and several other executives were sent to prison—Kapoor for 5.5 years, the others for lesser sentences. Kapoor was released after two years. As I understand it, he’s no longer a billionaire, but he’s not starving either.

Two years for killing 8,000+ people? You and I would do more time for robbing a convenience store.

Accomplices in Mass Murder

Big Pharma worked hand in glove with the insurance companies. According to the New York Times, “For years, the benefit managers [in the insurance companies] took payments from opioid manufacturers, including Purdue Pharma, in return for not restricting the flow of pills. As tens of thousands of Americans overdosed and died from prescription painkillers, the middlemen collected billions of dollars in payments.”

Fossil Fuel Companies

Combined profits for ExxonMobil, Chevron, Shell, and BP in 2023 totaled over $100 billion. Dr. Shaina Sadai writes that “Climate Analytics… research shows that, in just over three decades (1985-2018), fossil fuel producers made $30 trillion in profit while a partial accounting of damages linked to their products was $20 trillion.” Global Witness reports that “Fossil fuel companies that have sent lobbyists to COP summits produced enough oil and gas since the 2015 Paris Agreement to cause 17 million heat deaths this century.” [bold italics mine]  And that’s just heat deaths. Increases in volume of floods, vast areas of drought, increased frequency and strength of hurricanes have caused countless more.

He Didn’t Have a License

Luigi Mangione will likely spend the rest of his life in prison, and it won’t be a Club Fed-type institution. It seems obvious to me, actually, that if Mangione hadn’t been white and from a wealthy family, he’d be dead already.

I’m of the opinion that if the uproar sparked by his action brings us single-payer health care, he deserves a medal.